HEAVEN IS BARCELONA PERIOD.

I write from somewhere over the Western United States. I am on my way back from a truly memorable trip to Barcelona, aka Heaven.

This trip had its ups and down. Hey, anytime, one travels 18 hours to a foreign country, there are bound to be some ups and downs. However, with the exception of the stale air on the plane and the Vega General, or general strike, the trip was nothing but pleasure.

Barcelona is truly a special place unlike anywhere else I have ever been, and this trip did not disappoint. The weather was temperate. The food was delectable. The football was magnificent. The women were beautiful. The people were welcoming and down to earth. The art was masterful. The metro was clean, prompt, and efficient. In sum, the city was breathtaking in every way.

When I try to think of a city that resembles Barcelona, I am truly at a loss.  Sure, there are many other lovely European cities, but none comes close.  In my opinion, the city that comes closest is of all places Portland. Why? Plain and simple it is because of the shear passion and authenticity of the people in both places.  People care about the land in each place, People care about respecting other cultures and ways of life different from their own in each place. People have civic and regional pride in each place. However, Portland can only be considered a lighter, wetter version of Barcelona because of the greater diversity, history, and majesty of the Catalan capital.

One finds one's self drawn to people and places at various stages in one's life. For me, this is my Barcelona stage, and I do not see it ending anytime soon.  Summer family trip anyone? Sabbatical anyone?  I kid you not.  If I were ever to leave Portland, Barcelona would be the top of my list because of the focus on quality of life, work-life balance, peace, and pursuing one's dreams and aspirations.  

Only people like the Catalans that have suffered as much as they have under Spain and others can truly appreciate the value of life. Only a place influenced by so many different cultures and customs could be so tolerant.  They have seen tyrants, despots, dictators - all Spanish - rule over their land and repress their language and ways of life. It is that history as a backdrop that shapes the Catalan independence  movement. This quote from Napoleon sums up the Catalan people better than anything I could dream up: “Courage isn't having the strength to go on - it is going on when you don't have strength.” 

On November 26, one week from today, we will see what the Catalan people decide when they vote for the new regional government.  I, for one, will be watching.

However, whatever the people decide, I will remain a fan of the city by the sea named after its founder  the Carthaginian leader Hamilcar Barca.  

OLD TALE IN A NEWTOWN

Two days ago 20 beautiful first graders and 6 brave teachers lost their lives. No, this was not a school bus accident or a case of a communicable disease. It was another scourge, however, that took these lives - gun violence.

A deranged young man - it is always a deranged young man - gained access to his mother's vast arsenal. He first took her life. As if that were not tragic enough, he next forcibly entered her workplace - Sandy Hook Elementary School in his hometown of Newtown, CT.

For all we know he may have even once been a student in this same school. However, this did not deter him from brandishing a semi-automatic rifle and terrorizing the entire school and this community.

One can only imagine the screams of those young victims and the cries of those who fought to protect them in vain. The violence of that sound would be deafening. The violence of that sound would surely be seared into our collective consciences. The violence of that sound would surely not fade.

Sadly, the same had probably been said after Columbine, Blacksburg, Tucson, and Aurora. Yet each time, we have moved on. We have forgotten. Our will to have a constructive dialogue on this subject has always waned. Our collective disgust has always subsided. Our pledge to the victims and their families has always been empty.

Yet, Newtown feels different. Newtown is a moment that feels just like its eponym. We have the chance to make things better this time. To make something of this tragedy, to turn carnage into courage. The politics are never convenient or easy. They were not in Gettysburg in 1863. They were not in Selma in 1965. And they will not be in Newtown in 2012.

But the slaying of innocents comes at a time when a lame duck Commander-in-Chief who happens to be the father of two young children is in office. That man, Barack Obama, spoke in solemn tones on the day of the shooting and even more so at the Memorial service tonight. In his tears and through his eyes and words, I heard resolve. I heard empathy. I also heard a call to arms - not against those who fired the guns or who make them - but against ANYONE who would stand in the way of making this society safer for children and citizens, alike.

There can be no greater purpose for a society than protecting its children, he said. They are the most vulnerable among us. Yet, they are also the most important because they are our future. To paraphrase the historian George Santayana, any society that is not willing to protect its future is doomed to repeat the failings of its past. What will it be America? Let the names below be a constant reminder of exactly what is at stake.

GET BUSY DYING, OR GET BUSY LIVING

On the plane ride to Texas, I read - no devoured would be a more fitting description - Christopher Hitchens' posthumous memoir entitled Mortality. I found it somewhat uncanny that I read his book on December 15, 2012 - the exact one year anniversary of Hichens' death. May he rest in peace wherever he is.

In this book, Hitchens chronicles his struggle with metastatic esophageal cancer. His book is one of the most touching and moving descriptions of cancer that I have ever read, and I highly recommend it to you. By the end of an afternoon, you will have finished it, and you will be better off for having done so.

In case you are not familiar with Mr. Hitchens, he is a celebrated atheist and political and cultural critic. He famously decried belief in religion or God. He was a bold, boisterous thinker and speaker, and he made many enemies in his life. Not surprisingly, most of these enemies were on the right side of the political spectrum.

Hitchens' quick wit was matched by his taste for drink, smoke, and the fairer sex. He, himself, describes his hedonistic life in these terms: "In one way, I suppose I have been in 'denial' for some time, knowingly burning the candle at both ends and finding it often gives a lovely light." Poetic.

It is the juxtaposition of Hitchens' liveliness and the shear brutality of his cancer and cancer treatment that makes Mortality so compelling. For a man who does not believe in God or heaven, what drives one to fight for one's life? Simply put, it is love of life and all the people on this earth that make one's life worth living. In that sense, Hitchens is no different from any other cancer patient, but one can feel how much this life, the only life he believes matters or exists, means to him. 

I always respect my patients' right to fight for whatever they believe and to believe in whatever helps them get through the day. However, as a non-believer, I found myself strangely drawn to Hitchens and his approach to cancer - clinical, practical yet hopeful, but never sacrosanct or pitiable. Bad things happen to all people. Life is not fair. No one beyond ourselves can be blamed.

Hitchens writes evocatively of living dyingly with cancer. It is a reminder for us all who are well to live livingly, to enjoy every breath, every sip, every taste, and every moment. 

I quote another philosopher - the country singer Tim McGraw- when I attempt to inspire my patients who are in remission and those who are dying,  alike. I use the most simple yet powerful aphorism I have ever heard. 

Simply put, live like you were dying!

TOP CLASS

It is no secret that Nicholas is a soccer fan. However, it is also clear that he is becoming quite a soccer aficionado.

Today, I went to the pitch at my niece's school with her, Nicholas, and my dad. Nicholas was confident, poised, and deliberate. He looked and played like a mini version of his hero Xavi Hernandez, Barca's midfield maestro and possibly the best to ever play that position.

Nicholas' love of playing soccer is only matched by his love of studying it - watching highlights, reading magazines, looking at the "table," or standings, and constantly discussing the game with me. He loves that soccer is a global game, and he loves learning about the geography and history of the teams.

His knowledge is encyclopedic, and his tastes have become more refined. One recent morning he said, "Dad, I am getting tired of U.S. Major League Soccer. It is just not top class." He is 7 mind you.

With that in mind, after we played at my niece's school, we watched the highlights of the Club World Cup.  The final match pitted the Champions of Europe - Chelsea from England -  and the Champions of South America - Corinthians from Brazil. Chelsea lost the match 1-0. The lone goal was scored by Paolo Guerrero.

Afterwards, Nicholas said he was glad that Corinthians had won because they were from Peru, which is one of his favorite countries. I corrected him saying that Corinthians were from Brazil. He protested saying that one of the players was holding a Peruvian flag after the match. I said he must have been mistaken and changed the subject to avoid a fight.  We moved on, and this dispute never came up again.

However, before I began to write this piece, I read an article about the match. Guerrero, it turns out, is a Peruvian. I stand corrected about the flag.

Top class. Nicholas is top class indeed.

HEAVEN IS A PLACE ON EARTH... IN BARCELONA

I do not believe in God, but tonight I witnessed a piece of heaven on earth – an FC Barcelona match at the Camp Nou in Barcelona. I was seated in a prime viewing spot seven rows back from the players’ box at midfield, and no I will not be sharing how much the ticket cost!

The Camp Nou is the largest sports stadium in Europe, and it may well be the largest sports stadium in the world with a capacity of 100,000.  The stadium needs to be this big because countless hoards turn up for every home game to watch Messi and company work their magic. Tonight, was no different, and I witnessed the best sporting event – make that the best public event – of my semi-long life. 

First, the crowd was filled with people of all ages, races, and even genders.  Second, it was a decidedly family affair. A sweet little two-year old Catalan boy was perched on his mom’s lap next to me.  On my other side sat an older Catalan couple.  They seemed quite reserved… that is until the first goal.  After Messi put in the back of the net, the man turned to me and shouted, “Messi!”  I shook my head yes, and we smiled.  After Messi’s second goal, we high-fived, and I had made a new friend.

Despite the fact that we did not speak the same language, we clearly appreciated the masterpiece that was written by the Barca players on the pitch. The whole crowd appreciated that the players were not merely playing for them. These players were performing for the crowd, who witnessed football at its highest level. 

Ten of Barca’s starting eleven players came up through their youth academy, and so the club and the fans are almost like their family. One could feel sense the effusive pride with which these men played, and their love for the game was palpable and contagious.

However, I was struck most by the ease with which the Barca players played the game.  Nothing was forced. Everything was natural and well executed.  There was levity. There was skill. After the opposition Real Zaragoza tied the game, there was determination and Barca quickly regained the lead and did not look back.

Tonight was truly a night to remember.  I sent Nicholas live text updates during the game as he watched  home on TV.  I am sad Nicholas, Cate, and Kathleen could not be there tonight. Had they been with me, they would have witnessed something strange and unfamiliar in me – happiness and pure joy unlike anything in recent memory.

I will be back to the Camp Nou, and next time I will bring them along. Something as sweet as this time was meant to be shared, and I cannot think of anyone else with whom I would rather go to Heaven.

Visca Barca! 

P.S. Do not worry!  Once I get home, I will update this post and add pictures and videos!

THEN AND NOW IN BARCELONA

Tonight, I write from Barcelona. I was last here 14 years ago at the end of medical school in 1998.  Over the years, Barcelona has remained one of my favorite cities. Therefore, when the opportunity to present at an international meeting came up, I leaped at the chance. 

Much is the same in Barcelona- great food, great museums, friendly people, and beautiful women. However, as I wandered around town, I noticed a different mood in the city than the one I witnessed last time. There was a palpable sense of less hope, more dread, and more frustration. 

I witnessed all of these emotions yesterday as I walked the city on the day of the national work stoppage. People were striking due to austerity and the global economic downturn, and Spain has been particularly hard hit with employment around 25%.

I had thought that this was simply a transport strike, but I quickly realized the strike was more widespread when every destination I visited was shuttered.

Few people were mulling around in the morning, but they seemed more purposeful, more busy, and more serious than I remembered from my last visit.  Later, I noticed that crowds were gathering, and so were the police.  On the main drag called La Rambla, political signs adorned the lampposts. Some spoke of Catalan independence while others spoke of socialism without secession. The undercurrent of tension was to be found everywhere.

As I headed back to the hotel on foot, I noticed that the crowds had become considerably bigger and louder.  They were amassing in the city center in the Placa Cataluña.  There, I heard several loud explosions. Initially, I took them for gunfire or a bomb, but they turned out to be some form of firework.  Quickly, I headed in the opposite direction to my hotel.  I stayed in the remainder of the day and could not fathom how different this city that I love was on that day compared to my last visit.

It is true that it was a special day – a general strike. However, the city and the people of Barcelona were measurably different from 1998. It turns out that I, too, am different 14 years later. 

My last trip was all about pleasure and sight seeing at the end of four long years of medical school. This time, I am presenting at an international medical conference.  I have two kids and a wife whom I love, and I think about their future and the state of the world I will be leaving them all the time.  On this trip, I am less interested in partying and more interested in understanding and experiencing the Catalan culture and its people. 

There is no doubt that the Catalan people have been frustrated for hundreds of years.  However, during my last visit I had a simplistic, romantic ideal of the place.  That is no more.

In many ways, Barcelona feels more real and less ethereal.  That does not mean Barcelona is any less special to me. If anything, I am drawn more to this city – its emotions, its will, and its people… not to mention its Football Club. 

Now, Barcelona and its people just feel more grown up, more self-possessed, more introspective, but still hopeful… kind of like me. 

I have never seen a reflection of myself in a city until this trip, but Barcelona is not just any city.  

Visca Barcelona!

FORWARD!

Tonight was a great night! Tonight was an historic night! Tonight we re-elected Barack Obama as the 44th President of the United States.

This was a long campaign. This was a bitter campaign. However, this campaign also marked a clear line in the sand for American elections and the American electorate. Women won everywhere. Women carried the day everywhere. Minorities made their voices heard. Obama won them 80%-20%. The young overwhelmingly supported the President, too. In essence, the future of this country won while the demographics that have ruled this country for so long - the white, the old, and the males - lost, and they lost big.

It is hard not to feel that President Obama and the Democratic Party are on the right side of history and that they have grasped this moment.  What matters now is what they will do with that momentum.  Will they compromise, or will they project a positive vision for the country and try to bring their Republican opponents along? I hope that we will see a little of both.

Most importantly, what will the country make of tonight's Democratic victory?  Will the people raise their voices and rightfully demand that their leaders work for them?  I hope so because we have so much work to do. We must move forward on jobs, the economy, the debt, ending wars, and rebuilding this country.  Are we up for it? Are we as big as our politics?

The answer must be yes if we are to win the future and leave our kids a better country than we were given.  I am in awe of this victory, and I will soak it up.

However, I realize that the climb will be long. Obstacles, some surmountable and some insurmountable, will stand in our way. Those who would rather gum up the works rather than reform our political stalemate will persevere.

Despite this, I am more confident than ever that we are up to the task. Why? Any nation that can commit itself to electing an African-American named Barack Hussein Obama not once but twice is serious about progress. For these reasons, I am hopeful today. I am proud today. I hope you are, too, because today we are all Americans first. Today, we traveled a little farther up the mountaintop. We must keep moving forward!

HAPPY BIRTHDAY CATE REESE!

Cate turned four yesterday. Yes, I know it is hard to believe that time has passed so quickly since 2008, the year of her birth. 

We had a party for her at a local community center with some of her friends from school.  Our big girl said she did not want any presents. Rather, she said she wanted to do a book exchange where all the kids would get a new book to read.  We played games in the gym, ate bagels, and had cake with ice cream.

I was struck by how normal and at-ease Cate was and how she treated everyone with respect and care.  Again, hard to believe this was only her fourth birthday.

Today, we went to her school for a celebration.  I rushed from my morning meeting to get there and was met by Kathleen.  We sat in chairs behind Cate, who sat in a circle on the floor in front of us.  A poster with pictures of Cate from her four years was on the wall, and we told short stories about her.  Each of the children came up to Cate and wished her happy birthday. Then, each child went to wash up prior to lunch.  Very Montessori.

We stayed for lunch, and witnessed Cate get her lunch, set it up on a plate, and use her silver wear.  It is not to say she has not done this at home. However, she usually requests someone to help her or requests that someone make their lap available. I protest often, but I will miss having that little one so interested in our help.

We read stories tonight - Scooby Doo. She was Scooby, and I was Shaggy. We snuggled up, and she even let me give her a few smooches, which she usually fights.  It was a fun and relaxing night.

I look forward to many more birthdays with Cate, and I look forward to watching her continue to grow up.  She will have a major impact on this world one day. How do I know this? Because she has already made quite an impression on me!

Here's to Catherine "Cate" Reese Alumkal!

WATCH OUT!

Lately, Cate has been more into music and singing.  This is probably because of influences at school and because of Nicholas' love for music. I hope you enjoy her performance below.



I guess we need to sign someone else up for music lessons. It's a good thing we have an extra ukulele now that Nicholas has graduated to mandolin!

THE WINTER OF OUR DISCONTENT

Last week I had the pleasure of hosting a young woman named Winter Vinecki in my laboratory. I met Winter for the first time in Washington, DC several weeks ago at the Celebration of Science sponsored by the Prostate Cancer Foundation (PCF). 

Winter has been a fundraiser for PCF ever since she lost her father Michael Vinecki to prostate cancer when he was 40 - one year older than me. Since the time her father was diagnosed, Winter has been driven to help find solutions to the problem of prostate cancer.

Despite the fact that she is only 13 years old, Winter has raised nearly $400,000 for prostate cancer research, and I have been a direct recipient of her fundraising. Therefore, when a local TV reporter Tim Becker asked me whether I would be interested in hosting her and her mom in the lab, I leaped at the chance. 

I showed Winter how we grow prostate cancer cells in the laboratory and what these cells looks like under the microscope. I introduced her to the folks in the lab and tried to give her a sense of how much progress we as a prostate cancer community have made - five new prostate cancer drug approvals in the past two years compared with only one drug approval prior to that time - but also how far we still have to go.

I explained that very soon we will be initiating a $10 million project with 5 other centers on the West Coast to perform the equivalent of the human genome project in 300 tumors from men with prostate cancer.  While the original human genome project cost $3 billion dollars and took 13 years to complete, we can now sequence a tumor for around $1000 dollars in 2 days. Progress continues to accelerate, but for many patients and their families, progress cannot come fast enough. I feel their urgency every week in clinic, and that is what motivates me more than anything.

There are few heroes in this world who force us to question ourselves, our own commitment, and our own desire. Winter Vinecki is one of those people.  She plans to run 7 marathons on 7 different continents, she and has already completed her first in Eugene, Oregon. Kenya, her second, is next week.

http://www.koinlocal6.com/mediacenter/local.aspx?videoid=3761413

I told Winter that my son Nicholas often asks me, "Dad, why do you have to go to work at the lab every day ?" I told Winter what I tell Nicholas when he asks me that -  one death from prostate cancer is one death too many.
How can one give anything less than one's all?  How can one be satisfied with the treatment progress we have made in recent years? How can one rest when prostate cancer takes one Michael Vinecki from us every 16 minutes in the United States?

The answer is we cannot, and we will not.  For Winter now inspires me, too. 

Julian Castro, the keynote speaker at the Democratic Convention last month in Charlotte, said that the American Dream is not a sprint. It is not a marathon. It is a relay. We are all linked. We are all in this together. The cure for cancer is no different.

I am honored to be a member of Team Winter, and I will do my best to follow her example... and to keep up with her tireless efforts and endless accomplishments so that one day our discontent with prostate cancer outcomes may turn into content.

CELEBRATION OR SEQUESTRATION

Last weekend I was in DC for "A Celebration of Science." This event was organized by Michael Milken, who founded the Prostate Cancer Foundation that funds some of my research.

The weekend's festivities were designed to shed light on the importance of science. Specifically, this event was designed to remind stakeholders - lawmakers, scientists, voters - that science is the best investment a country can make. This is because science funding creates jobs; science funding promotes the careers of young investigators and encourages even younger investigators to enter into scientific fields; science funding leads to new discoveries that launch new companies and drug development; finally, science funding leads to new treatments and cures that reduce health care costs, improve patient survival and productivity, and increase national competitiveness.  The arguments were straightforward, but they were sprinkled with passion and a few tears.

When I began medical training in the mid 90s, HIV was a death sentence. However, patients with HIV are now living long and living well because of combination anti-retroviral treatment. We met the Berliner patient. This man was HIV positive. Then, he developed leukemia that required a bone marrow transplant from another individual after high dose of chemotherapy. Not only was his leukemia cured, but so was his HIV. He is the first and only person to be cured of HIV. Let's hope he is not the last.

We met Winter Vinecki, an amazing 13 year-old whose dad died of prostate cancer at an age close to mine- 40.  After his diagnosis, Winter decided that she had to do something. Therefore, she began running races to raise money for prostate cancer research. In the last three years, she has raised over $300,000 for prostate cancer research. Her goal is to run a marathon on every single continent, and she is already on her way. 
What a hero!

At nearly every event, Democratic and Republican lawmakers were in attendance.  They spoke of the importance of science and progress. The Democrats talked about how funding must be expanded and not just kept at its current level. Eric Cantor, the House Majority Leader, however, demurred and did not offer any specifics. Surprise. Surprise.

If a budget agreement is not reached before the end of the year, the budget will go through a process called sequestration. This means that defense spending will be cut, and all non-defense spending will be cut by 8% per year. This includes science funding to the National Institutes of Health (NIH). Because of Washington's dysfunction, sequestration seems imminent.

However, despite the reality of a shrinking budget and the failure of Washington to lead and invest in science, I am more motivated than ever to find new treatments and an eventual cure for cancer.  People like Winter, the other researchers, private foundations, the leaders of the NIH, and receptive congressmen give me hope. They all understand that life only improves through scientific investments.

We saw living proof of what science funding can do this weekend, and it is time for us all to decide what our health is worth. Write your Congressman and Senator! Take an active role in this decision! It is not only your health that is at stake but the health of our entire nation and the world.

PRIDE

Most days, I am very proud to be a Democrat. This is not a difficult task in liberal Portland. However, tonight Democrats in every part of this land had reason to be proud after witnessing some of the speeches at the Democratic National Convention in Charlotte, NC.

First, Julian Castro, the young mayor of San Antonio, delivered an absolutely inspiring speech about his story. It was a story about hope, opportunity, and hard work.  It was an American story - an American dream. The best lines of the speech reminded viewers that we are all connected and not just in it for ourselves. He said, "My mother fought hard for civil rights so that instead of a mop, I could hold this microphone" and "the American dream is not a sprint, or even a marathon, but a relay." Wow!

Next, First Lady Michelle Obama took the stage. She reminded voters of where she and President Obama came from. She also reminded voters about how their family's struggles made them who they are and how these experiences give them an appreciation for what people are going through.  She said that the fights President Obama has picked are not political but personal and based upon his unwavering desire to help others rather than himself.  No one could have made that case more clear or compelling than Mrs, Obama, and I hope America was listening.

Both of these speeches reminded me that my story is no less remarkable.  My parents moved half way around the world to Canada for educational and economic opportunities that still do not exist in India. Then, they left comfortable lives and took one more step forward - this time to the U.S. - the land of ultimate opportunity. They did not do this for themselves but rather for their kids.  We, kids, learned first hand about sacrifice, hard work, and desire. These experiences made me who I am and still inspire me to this day.

My children like Mitt Romney, will probably never know economic hardship or have a sense of being on the outside looking in because of our station in life and where they will grow up - tolerant, liberal Portland. However, I am already trying to teach them that to whom much is given, much is expected. We do not measure success by our bank balance. Rather, we measure it be the ways we help other people or the ways we make this world better.

Privilege can be poisonous (see Romney, Willard Mitt). However, privilege can also serve as a tool to remind one how lucky one is how important it is to help those that have less than one's self.

Those are the values with which I was raised. Those are the values that we heard about tonight. Those are the values that are worth fighting for - even dying for.  I hope Nicholas and Cate were listening tonight. I hope they were watching their mom and dad tonight, who were moved beyond words to be a part of this Democratic Party.

PORTLAND, WE'VE GOT A READING PROBLEM!

They call Portland "the city that reads." To any of you that think this is hyperbole, Portland is the home to Powell's Books, the world's largest independent bookseller, and Portland has the largest number of people per capita with library cards.  I offer one other piece of evidence below that demonstrates how well-utilized our public library system is and how competitive our public library system users are. 

Today, approximately two hours ago on this Labor Day holiday, the New York Times writer Nate Silver announced his new book release.  Immediately, I went to the Multnomah County Library website to place this book in my queue.  What did I find?  Twelve other people had already beaten me to the punch.  Twelve people on a holiday within two hours!

I never thought I would rage against reading well or being well-read, but Portland, we've got a problem!

FAR TOO SOON

Tonight, I received an email from Arbor notifying me and other members of the community that the mom of one of Nicholas' classmates passed away from a short struggle with breast cancer.  She was a few years older than me and leaves behind a second grader, a kindergartner, a toddler, and a devoted husband.

I did not know this mother well.  I had only met her once or twice, but I was always struck by her devotion to her kids and her sense of the importance of the here and now.  Her daughter is very bright and driven, and I think I know from whom she gets those attributes.  This mom will be missed.

I lose patients every month, and it never gets easier or less painful. Most of these men are in their 60s or 70s, and they have lived long, full lives. Their children are grown, and many of their grandchildren are grown, too. However, one death from cancer is one death too many.

There are no words that can comfort a child who has to bury one's parent regardless of the child's age.

There are no words... beyond I'm sorry, and I'm here for you.  That is what I tell the families of the patients whom I lose each time.

I also tell them that their loved one is in a better place now, that their loved one feels no more pain, and that their loved one is watching over them.

I know that time heals most wounds, and I also I know that we as a community can help with that healing. We will be there to help this child and this family in any way possible.

Sometimes life is unfair, and the lives of extraordinary people are just too damn short. This is one of those times.

A CAUTIONARY TALE

Yesterday, I went to the Portland Timbers' game with my friend Jason. We parked and waited for the light rail to take us to the stadium. While we were waiting, we witnessed a sad and violent act.  A father yanked back a young boy - no older than 5 - who had motioned to step into the street. Mind you, no car was coming.

The man then proceeded to spank his son and yell at him in public.  The boy began to cry - no weep - as we all witnessed this unpleasantness.  The father ignored the boy and continued to check his smartphone through several minutes of sobbing.  It was the juxtaposition of force and neglect that was so powerfully sickening.

I felt badly for the boy. However, I also felt badly about myself because of the times I have failed to be patient enough or thoughtful enough with my own children. I have never laid a hand on either child, but I certainly lose my temper at times.  It was jarring to see how easily and naturally that father's actions seemed to him and how easy it is to fall into that trap.

I want to believe that that father was having a bad day and that he feels as sick as I do just thinking about what happened.  I want to believe that his actions might yet have a positive effect - on teaching the boy about street safety- and on those like me who will hopefully think twice before letting frustration bubble to the surface.  Life is too short to mistreat one's enemies, let alone one's loved ones.  Let this be a lesson!

BLOSSOMING BEFORE OUR EYES

This weekend our family pitched in at the Arbor School Summer Work Party. At this annual event, families - new and old - pitch in to help clean up and beautify the campus and perform whatever tasks are necessary to get the school ready for Fall.  Nicholas and I helped shelve books and break down old encyclopedias so that the paper could be recycled.  Kathleen and Cate helped in the garden. Afterwards, we all celebrated our efforts with lunch.

More than anything, the day is a chance to welcome the new families and re-engage after two months away. The day also served as a reminder of the swiftness with which times elapses and how much Nicholas and Cate have changed in the two years since he began school there. In almost every way - physically, mentally, and emotionally - Nicholas and Cate have grown so much.

Here is a picture of Nicholas with his beloved teachers from kindergarten and first grade - Lori and Toby from June. Since then, Nicholas has probably grown several inches. He has graduated to playing the mandolin from the ukulele, can almost swim, and is turning into one heck of a soccer player.

Here are some pictures from the work party with Nicholas in various states of action.

Just one year ago, Nicholas was afraid to try to go up the treehouse because he was concerned that he would not be able to come down.  On this day, he suggested we go up and climbed up all by himself.  I spotted him on the way down, but he made his way down all by himself.

Confidence. That is the word that describes this young man. That and kindness and passion.  What wonderful attributes.

Nicholas has truly made the most of the opportunities he has been given, and he has really come into his own.  His knowledge is encyclopedic. His interests are ever-changing. His character continues to solidify and become more steadfast.

This inscription below from the Arbor treehouse captures what has come about in Nicholas - a sense that anything is possible and that he is capable of greater things than we or he could have ever imagined.

Incidentally, Olivia was an eighth grader when she built the treehouse.

Here's to Nicholas, and here's to another wonderful year ahead at Arbor.

A HEART OF GOLD

One of Cate's teachers at school loves to play the guitar and serenade the kids.  In recent weeks, she has come home singing classics like Oh Susanna and the like. However, I was shocked to hear her singing "Heart of Gold" by Neil Young, which is a true classic.  Here is a rendition by Cate as she watches a live performance of the song on Youtube. Her version is includes her trademark raspy voice and harmonic sound effects. Enjoy!

ALL DOWNHILL FROM HERE

The photo below contains one of the best moments of my life to date.

What an honor. It is all downhill from here after meeting the President...

THE ROAD WE'VE TRAVELED

Continuing on the theme of the President's re-election, you should watch this video if you have not already.  It sends a powerful message about how far Americans have traveled with this President in the past four years. My favorite part is at 2:40 with David Axelrod.

FORWARD

Today, I attended a fundraiser for President Obama in Portland.  I normally have clinic on Tuesdays, so once I heard about the event two weeks ago, I moved my patients to another day so that I could attend.  Thankfully, it all worked out.

I had heard President Obama speak on three occasions previously when he was a candidate for the Presidency. However, this was the first time I had a chance to see him since he took office.

The event was held at the Oregon Convention Center, and people of all ages and colors lined up outside to get a chance to hear the President speak and to catch a glimpse.  We were served lunch, and then many of us had the opportunity to meet the President and have a photo taken with him.

There were families, couples, and individuals who came alone like me.  When my turn came, I said hello to the President.  He was slightly taller than me and thin.  His hair was more salt than pepper, and he had a kind and welcoming expression on his face- like a teacher with new pupils on the first day of school.

We shook hands, and then we put our arms around each other's backs for a photo.  Afterwards, I grasped his hand.  I said, "Thank you for all that you have accomplished these past four years, and thank you for all that you will accomplish in the next four!" He said, "Thank you!"  With that, we parted.

It is rare that I am at a loss for words, but that brief encounter took my breath away.  Here, I had met the most powerful man in the world - my hero and the most accomplished President of my lifetime. What an honor and what an occasion.

Afterwards, I had a seat close to the front to hear him discuss his vision for this country and for the next four years.  President Obama talked about how far we have come since 2009. He talked about what drove him - to create policies that help the most people possible and to restore a sense of possibility in this country. He talked about his own family and about how their experience was America's experience. He expressed a belief in the American Dream - if you work hard, you have a chance to be successful.  His message came down to one of hope and perseverance, and the desire to leave this world better than how he found it.  One word more than any other summarizes his vision - Forward. Much of his remarks can be seen in the video below.


 
I feel lucky tonight. Not because I shook the hand of the leader of the free world. Rather, I feel lucky because I live in the free world and have a President who shares my vision and my dreams for that world.  More than anything, when I look at the President, I see possibility and opportunity. I hope my children see the same thing and that they know that hard work can allow one to scale any obstacle and overcome any challenge.  If they doubt me, I will show them that photo of me with the President once I receive it. I hope it will remind them of just what may be possible for them, too,... if only they set their minds to it! 
 
Forward!

PROFILES IN COURAGE

Everyday I am struck by how brave my children are. This is especially true when I drop them off at camps or at school. When I was Cate's age, I had never been outside of the house alone. When I did start nursery school, or pre-K, at the age of four, I would cry every morning. On the other hand, our kids have been taken care of by other people since the age of four months.

You may not have ever heard of the term before care or after care. However, for our kids these are natural parts of their days- days spent outside the home. This morning, I dropped off Cate at her camp at school with an unfamiliar teacher. Cate was a little hesitant to go in and needed an extra hug, but she did go in without a fuss. Afterwards, I drove Nicholas to Zoo Camp.

We lined up to enter with the other families outside the gate. As I stood there in that queue, I was struck by just how independent and brave my kids are. Here, Nicholas was about to go into a situation where he knew no one and where he would spend the entire day. He did not have the least bit of trepidation. The forecast said it was supposed to get up to 80F that day, so I had dressed Nicholas in shorts. However, as we stood in line, it was quite chilly - 50F or so. Nicholas had his jacket, but pangs of guilt hit me.

I was not just upset that I had not dressed him appropriately. Rather, I was also sad about having to outsource so much of his upbringing and care to others. This is the price you pay for being a two-parent working family. This sacrifice is nowhere to be found in the medical school brochures.

I love my job and appreciate the flexibility of research. If I were in practice, like Kathleen, my hours would be worse, and a school or camp drop-off would be unimaginable.

Fortunately, Kathleen will be cutting back to three days per week this summer. I will also try to do a better job of being more engaged with the kids in the free time that I have. Their courage and self-reliance is inspiring, but it also makes one more than a little sad.

COORDINATION

The other day, we were at the soccer field. Cate noticed a basketball on the adjacent basketball court.  She went over and picked it up, and I was not prepared for what came next.

I had witnessed Cate watching people play on the court before, but I had never seen her dribble a ball herself.  Well, dribble she did.  She could have gone on for days like that, and had perfect control.


I am beginning to wonder what physical activities and sports Cate will not master.  Scholarship, anyone?

MOONRISE KINGDOM

Yesterday, I saw Mr. Wes Anderson's new film "Moonrise Kingdom."  I have been a fan of Mr. Anderson since medical school when several of my classmates, who had attended prep school with Mr. Anderson, introduced me to his work.

Therefore, when his first film "Bottle Rocket" came out, my friends invited me to the Houston premiere at the old Landmark River Oaks Theatre.  Since that time, Mr. Anderson has made several other films.  The highlights include "Rushmore," "The Royal Tenenbaums," and "The Fantastic Mr. Fox." However, Mr. Anderson's latest film "Moonrise Kingdom" comes as close as humanly possible to perfection.

The movie tells the story of two middle school-age children living in an island off the New England coast. Sam is an orphan and a Khaki scout - think boy scouts with snappier uniforms.  The other protagonist is Suzy, a young girl full of life but also anger.  These kids orbit different worlds, but each child's world is populated by burned out or inept adults.  The contrast between the children's vibrancy and the adults is striking, and it makes Sam and Suzy quite compelling and likable.

The New York Times site features the scene in which Sam and Suzy first meet with commentary by Mr. Anderson. It is easy to forget during this scene and the rest of the film that these actors are children. They each inhabit their characters. Their chemistry and "love at first sight" is palpable, and one cannot help root for them.

More than anything, when I watched "Moonrise Kingdom," I was blown away by the passion that each child had for the other. Despite the fact that they had only met once and that their relationship was exclusively epistolary before they run away together, their connection was obvious.

The film reminded me of the first time I fell in love as a teenager, and it brought back all of those emotions and memories.  I was reminded of what it felt like to let my guard down, to invite someone in, and to risk rejection because not making one's feeling known would have hurt far more.  I will not spoil my adolescent story's ending or the movie's ending. Suffice it to say that they are different.

Far too often as we get older, we settle. We accept what is just all right because we have either lost hope, patience, or the belief that we deserve something better.

Perhaps settling is what it means to grow up, but we seldom realize that this is what our adult lives  have become.

"Moonrise Kingdom" was a reminder of what we all once were. However, "Moonrise Kingdom" is also a reminder of that for which we all may still strive - despite the extra pounds, lost hair, or wrinkles -  love, passion, and an endless sense of possibility despite what the world might throw at us.

I will leave you with the song that ends the film (NOTE: Stay for the entire credits because a treat awaits you!).   Fittingly, this song is sung by a children's choir.



In that final scene, we come to understand the meaning of the film's title. However, we also see a slice of heaven on earth that need not belong to just the young.

NUMERO UNO

Little Cate is one of the most competitive people whom I have ever met.  Her killer instinct shines on the soccer field, but it shines even brighter every other night when she and I play Uno prior to reading bedtime stories.

She and I go for the jugular, and we call putting down a draw two or a draw four card drawing blood. The games get pretty heated, but each of us is a good loser.  I always congratulate her when she wins, and she does not (often) cry when she loses.

The instructions state if a certain card color is in play, a player must play a card of that color if he/she has it.  The other night I said Uno and had just one card left in my hand after playing a green card. I waited to see what Cate would do.  Truth be told, I knew that she had green cards in her hand.  Cate proceeded to draw a card- presumably with the hope that she would get a draw two or draw four that she could play against me to stop me from winning.  To no avail, she did not get one of these cards.  I played my last card and won.

However, afterwards I asked Cate if I could see her cards.  Cate must have sensed that she was about to be busted for not playing a green card because she proceeded to sit on her cards.  I told her that if she wanted to play again that night, I needed to have her cards back so I could shuffle the deck.  She still held back.  Finally, I handed her a stack of cards and asked her to mix her cards in.  It just so happened that the cards I gave her did not have any greens.  She mixed in her cards carefully while I closed my eyes.  Afterwards, I sifted through them and asked her about the new greens that had appeared.  I was smiling and cracking up.  She smiled, too, but was obviously embarrassed because she kept saying, "Dad, don't laugh!"

I shuffled the cards up and we played again.  This time, she won fair and square, and I gave her a big hug. That's my girl!

INDEPENDENTS' DAY

Every year, each student at Arbor from K through 8 is in charge of picking an independent project.  This year topics in Nicholas' class ranged from omelets, finches, skiing, and rock candy.

This year, Nicholas and I began to closely follow the English Premier League.  Many consider this to be the world's best club soccer league, and this year is considered the greatest season of that greatest keague. Nicholas and I could not agree more.

I asked Nicholas why he picked the Premier League for his project.  He said he loved the team names, the crests, and the players. Enough said.

One and a half weeks before the project was due, we went to the art store and picked up a posterboard, ruler, fancy markers, a Pentel mechanical pencil, and Staedtler erasers.  The last two items reminded me of my own childhood and my love of fancy office supplies.  My dad used to be me many pencils, erasers, and pens.  Collecting these was one of my early obsessions and compulsions, and buying those items brought back a flood of good memories.

Each night, we spent about one hour working on the poster. First, Nicholas used a ruler to mark straight lines on the poster so the writing would be straight. Then, he wrote out all the text in pencil with his best handwriting. Next, he wrote over the pencil with markers and erased the pencil marks.  For the table, he drew all the teams' crest, and he filled in facts about the teams.

Here are the crests of the 20 teams. Click on the picture for a closer view of Nicholas' handiwork!

Then, we found pictures to put on the poster and organized them with topics of his choosing.

To put such a poster together is quite a feat, but the students also present their work in front of their classmates and take questions and comments.  Nicholas' presentation is below.



Here is the Q and A.



I was so impressed by this young man. Let me remind you he is six years old currently.

I was tough on him when he was working on his poster because I knew how good he was capable of making it.  There was a lot of erasing, concentration, and a few tears of fatigue and frustration.

After the presentation, Nicholas and I reflected on what he had accomplished.  I asked him if the hard work was worth it.  He did not hesitate and said, "Definitely!" I could not agree more.

Atta boy!

I LOVE THE GREEKS

Nicholas' class has been learning about the Ancient Greeks.  This is one of the favorite subjects in the Primary classroom, and it is for good reason.  The students learn about Greek Mythology. They sample Greek food. They learn the Greek alphabet. Finally, they also put on a Greek play.  For many students, like Nicholas, this is their first chance to act and perform in a play.

After several weeks of practice, the big day finally arrived to perform "The Golden Apple."  We picked up our programs, which had info about all of the actors and their interests.

Nicholas' bio is shown below.

Then, the performance began.



As you might have figured out, our little guy played Paris and married Helen played by the adorable Harper. Afterwards, we joked with Harper's family that we were glad that these two kids had found each other and that we awaited the dowry.  They said the farm animals were en route.

What an amazing and early introduction to the arts and literature.  I look forward to many more plays and many more years of watching Nicholas do his thing. Also, let's hope his eventual marriage is more calm than Paris' and Helen's- that one spawned the Trojan War!

BITS AND PIECES

Every few months, Arbor invites its students to perform in front of all the students, staff, teachers, and parents who are able to break away in the middle of the day. The event is called "Bits and Pieces," and Nicholas played his ukulele once before and did a great job.

When, the school announced this was coming up again, neither Kathleen nor I mentioned it because we wanted Nicholas to decide for himself whether to play a piece.  One week before the latest installment, Nicholas' music teacher Laura told us she was excited to hear his new piece and wondered if we would be able to make it.  Kathleen told her we were not even aware he would be playing, but that we would make every effort to come (i.e. Joshi will be there).

We asked Nicholas what he intended to play that night, and he said "Hedwig's Theme" from Harry Potter.  He had learned that songs several months prior, and he thought his classmates would appreciate it since many of them are Harry fanatics.  As I have said previously, Arbor is an eco-friendly Hogwarts without the house of Slytherin!

On the day of the performance, several older students played along with their personal music teachers.  Nicholas was one of the youngest performers, and he confidently strode up to the stage all by himself.  He set up his music, got out his pick, and announced that he would be playing "Hedwig's Theme."  He then proceeded to give it his all.  You can see for yourself below.



As you can tell from the applause, it was a big hit. When Nicholas returned to his seat, his fifth-grade "buddy" Norris and all of the kids sitting nearby gave him big high fives and words of congratulations.
Every single performer receives this type of reception regardless of the number of missed notes or pauses.

For me, the bravery of the performers and the grace of the audience is what exemplifies the Arbor School- character, intellect, and curiosity.  Here's to Nicholas and to many more Bits and Pieces.

COOLING OFF

We have been experiencing a mini heat wave in Portland with temps in the (oh my God) 80s.  To cool off, we set up the sprinkler for the kids.  As you can see, they are hoping for more warm weather!

DRINK IT IN!

Today, I witnessed the most remarkable and dramatic sports comeback of my life.  Going into today's game, Manchester City (aka City) were on the top of the table by a whisker over their cross-town rivals Manchester United (aka United).

I use the term rivals, but until recently these two clubs have been orbiting different galaxies with United in the Milky Way and City far off in some distant, unheralded galaxy.  United has won 14 of the 20 Premier League titles in England's first division since 1992 when that league was created.  City, on the other hand, had not won a league title in 44 years.

Today, none of that history mattered as both club were resolutely playing for the moment.  All City had to do was win, and the title was theirs.  They faced the fourth worst team in the league Queens Park Rangers (QPR). That might sound like an easy win for City and no contest, but in English football the three worst teams are relegated, or banished, to a lesser league. Relegation means far fewer TV revenues and much less prestige.  Therefore, QPR came looking to fight, and fight they did.

City, like United, took an early lead in their match. However, unlike United, City gave away a goal.  This meant that they had to score one more or they would lose the match and the Premier League title on this last day of the season.  City were handed a gift, albeit a just gift, when the QPR midfielder Joey Barton was dismissed with a red card for elbowing a City player in the face.  It was crass and deliberate.  However, despite being down to 10 men, QPR continued to fight, and they scored another goal to take a lead 2-1.

This is where things stood at the end of 90 minutes of regulation. In football, unlike other sports, there is added time to account for stoppages or delays during the match.  Five extra minutes were added to this match- the majority of which were due to that elbow incident.  By this time, United had won their game and had every reason to believe that City would lose and that they, United, would retain the title.

Yet, sometimes in sport, like in life, the unexpected and the impossible happens.  Today was one of those days.

In the 92nd minute, City dramatically equalized the score on a header to give themselves a lifeline. At about that time, QPR heard word that the third worst team, Bolton, had lost and that Bolton and not they would be relegated.  The QPR players on the sideline began to celebrate, but City remained resolute and showed no sign of wavering.

Belief plus talent is a dangerous combination.  Would it be be enough? Would their be enough time?

Within seconds, the Argentinian forward Sergio "Kun" Aguero scored again to give City the lead.  The entire stadium and every "noisy neighbor" as the United coach Sir Alex Ferguson previously dubbed the City faithful erupted in joy.  You can witness this moment for yourself below.



While neither United nor City are my team, City are my favorite squad in the Premier League due to their attacking and aggressive style of play. I was overjoyed and overwhelmed by their victory and by how they won it.  I brought down Nicholas to watch the replays, and we discussed the match much of the day. What a moment!

He and I will surely remember this day, this win, and this season in the Premier League.  Nicholas will discuss this League for his independent project at school sometime in the next few weeks, and he will have a lot to share about what many are calling the greatest season in the history of the greatest football league in the world.

To City and to believers everywhere, let's all raise a glass.  As the great Martin Tyler said in the commentary above. Drink it in, City!

A MODERN DAY SIDDHARTHA

Just when Barca fans thought that things could not get any worse, our coach Pep Guardiola announced that he was leaving the club last Friday.  This announcement did not come as a complete surprise since Pep has stipulated that he have one-year contracts with the club since he became coach.  This season, in recent weeks, Pep has shown particular strain .

Guardiola's record in four years at Barcelona is unrivaled. In 243 games during his era, Barca won 176, tied 46, and lost just 21. During that time, the team won 13 trophies out of 16 competitions in which they participated.  These trophies include three consecutive Spanish League titles, two European Championships in three years, and two Club World Cup Championships in three years.   Despite (or rather because) of that success, the pressure to win every single game became enormous.  When one plays a game every three days each year because one is vying for so many titles in so many competitions, such expectations become even more untenable.

Guardiola cited the stress of his position rather than failures in several of this year's competitions as the reason for his departure, and one cannot begrudge him.  His joy had left him despite being surrounded by the world's best players, a supportive front office, and a generous salary.  His break is well-deserved.

However, despite leaving the club, Guardiola's legacy will endure.  His assistant coach Tito Villanova has been named the new coach, and these men share the same love of the game and philosophy of play.  

The Barca style is so distinctive - it looks like a symphony on grass.  I was drawn to this sweet music the very first time when I watched Spain play in the World Cup.  Only later would I realize that Barca was the inspiration for this quick-passing, fluid style of play and that Guardiola was its composer.  While this style of play began under his Guardiola's coach at Barca, Johan Cruyff, it is said that Guardiola perfected it.  

Results speak volumes, and it is hard to disagree with Pep's record and the number of soccer acolytes whom he has inspired. However, Pep's take was decidely non-teleological at his press conference announcing his departure. When he described his tenure as coach, he said, "‘I don’t remember any single title, rather the emotion I shared with my players... more than about the results, I'm satisfied about the way we have done it." 

Well said, maestro. Spoken like a modern day Siddhartha.